Provider Demographics
NPI:1073823647
Name:NICHOLSON, ROBYN NEILL (MA, LPCA)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:NEILL
Last Name:NICHOLSON
Suffix:
Gender:F
Credentials:MA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2124 CROWN CENTRE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7803
Mailing Address - Country:US
Mailing Address - Phone:704-849-0144
Mailing Address - Fax:704-845-1611
Practice Address - Street 1:2124 CROWN CENTRE DR
Practice Address - Street 2:SUITE 400
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-7803
Practice Address - Country:US
Practice Address - Phone:704-849-0144
Practice Address - Fax:704-845-1611
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8152101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional